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Scoliosis is an abnormal curvature of the spine that occurs most before puberty during the growth spurt. Most cases of scoliosis are mild. However, it can get more severe, particularly as children grow. People with severe scoliosis may need surgery to treat their condition. Scoliosis surgery is the most extensive type of treatment for scoliosis. Besides for those with severe scoliosis, surgery may also be considered if:
The curve is getting significantly worse.
The curve is greater than 40 degrees.
The curve is interrupting your daily life and causes discomfort.
You experience severe back pain.
Other treatments have not helped your condition.
The nerves in your spine are being squashed or irritated.
There are several types of scoliosis surgery, including spinal fusion, growing systems (insertion of special rods), and fusion-less. The type of surgery you will get usually depends on your age and the severity of your scoliosis.
Spinal fusion is by far the most commonly performed scoliosis surgery for teenagers and adults. This surgery involves fusing two or more adjacent vertebrae (the small, interlocking bones of the spine) together, which will cause the vertebrae to grow together at the spinal joint and form a solid bone that cannot move independently. This will limit the movement of your spine.
The vertebrae are fused together using a bone graft, screws, and rods. The rods keep your spine in a straight position, while the screws hold them in place. The bone graft and vertebrae eventually fuse together into a single bone. The procedure is typically performed under general anesthesia.
Fusionless surgery is a relatively new approach to treating scoliosis. As opposed to spinal fusion, which limits movement and growth, fusion-less can preserve the movement and growth of your spine and this type of surgery is usually done on children.
Fusionless surgery involves applying constant pressure on the outer side of a spinal curve. It aims to slow or even stop the growth of the curve’s outer side, while the inner side can continue to grow normally. Over time, the lateral curvature should reduce as the spine becomes straighter.
Growing system (special rods)
In younger children, generally those under the age of 10, surgery to insert special rods alongside the spine can be done. The rods are anchored to the spine to help maintain or correct the spine’s curvature while the child grows. After 6 to 12 months, the child needs to return to their specialist to have the rods lengthened to keep up with their growth. This can be done in two ways:
Through a minor surgery in which the rods are extended through a small incision in the back.
Using a remote control that can activate magnets inside the rods. With this procedure, no cuts are needed to lengthen the rods.
This type of surgery is done in young children because if spinal fusion is done at too young of an age, it could cause several complications, such as less room for the lungs to develop.
Although it depends on the type of surgery you underwent, you may need to stay in the hospital for two to seven days. Children may need to stay longer, usually for 10 days. It is recommended that you stay in South Africa for about eight to ten more days for follow-up checkups and stitches removal.
Full recovery can take about three to six months. However, school and work may be resumed after 4 to 6 weeks. Children may need to avoid sports roughly a year after surgery, while adults may need to avoid strenuous activities for a few months.
After surgery, you may need to wear a brace to keep your spine in proper alignment. You may also need to learn new techniques to sit, stand, and walk safely. Physical rehabilitation is recommended to help you learn ways to move safely and to strengthen your back.
Spinal fusion surgery has a high overall success rate. The University of Washington’s Department of Orthopaedics & Sports Medicine reported that spinal fusion can achieve approximately 70% curve correction and has around 2 to 3% chances of complications when performed on someone under 16 with idiopathic scoliosis. However, the data for fusion-less surgery is not yet available.
As with any surgery, scoliosis surgery carries some risks, such as infection, pain, nerve damage, failure to heal, and excessive bleeding.
If the scoliosis isn’t severe, your doctor may recommend the following:
Exercise – you can talk to a healthcare professional about an exercise program to strengthen and stretch your back.
Spinal injections – if scoliosis irritates or puts pressure on the nerves, your doctor may inject steroids to temporarily ease your discomfort.
Back braces – these are usually recommended for children, although adults may also benefit from using them. A back brace can help support your back and stop it from getting worse.
Before scoliosis surgery, your scoliosis can be severe, cause pain, or prevent you from doing your normal activities. After surgery, you should be able to enjoy your daily activities without discomfort or pain.
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